Optimizing strategies for malaria surveillance and measuring the impact of contro

需要在疟疾流行国家建立监测系统，以获取有关干预措施覆盖范围和疟疾传播、感染和疾病变化的信息。重要的是，监测数据必须有效地传达给政策制定者，为未来的干预策略提供信息。然而，目前非洲大部分地区开展高质量疟疾监测的能力不足，现有的卫生信息系统也不足以监测疟疾控制方面的进展。关于病媒行为和传播强度的数据没有得到很好的收集。在卫生设施收集的发病率和死亡率数据可能有偏差，往往不完整、不准确，在没有实验室确认的情况下主要依赖临床诊断。社区调查是目前疟疾监测最有力的战略，但成本高昂，后勤上具有挑战性，在有限的地理覆盖范围内很少进行，并且不够全面，无法充分捕捉传播，感染和疾病的动态。确定收集可靠疟疾监测数据的最佳方法对于提高我们对疟疾流行病学的认识和为最大限度地发挥控制干预的作用提供证据基础是必不可少的。对于该项目，将在流行病学差异很大的3个森菲内尔地点进行全面的疟疾监测研究，以收集传播强度、感染和疾病的数据，并确定最佳监测方法。监测活动随后将得到简化，并扩大到6个哨点，以衡量关键疟疾控制干预措施对疟疾传播、感染和疾病的影响。我们的具体目标是：（1）通过在具有不同传播强度的多个地点比较不同的方法，确定乌干达疟疾监测的最佳策略，（2）利用乌干达多个地点的监测数据，估计关键疟疾控制干预措施对传播强度、感染和疾病措施的影响，对疟疾控制干预措施进行经济评价，以确定最佳覆盖水平和 在乌干达的多个地点进行干预。

Surveillance systems in malaria endemic-countries are needed to capture information on intervention coverage and changes in malaria transmission, infection, and disease. Importanfiy, surveillance data must be effectively communicated to policy-makers to inform future intervention strategies. However, the capacity to conduct high-quality malaria surveillance is currenfiy inadequate in much of Africa and the existing health information system is insufficient for monitoring progress in malaria control. Data on vector behavior and transmission intensity are not roufinely collected. Morbidity and mortality data collected at health facilities may be biased and are often incomplete, inaccurate, and largely rely on clinical diagnosis in the absence of laboratory confirmation. Community surveys are currenfiy the most robust strategy for malaria surveillance, but are expensive and logistically challenging, conducted infrequently with limited geographic coverage, and not comprehensive enough to fully capture the dynamics of transmission, infecfion, and disease. Identifying the opfimal methods of gathering reliable data for roufine malaria surveillance is essenfial for improving our understanding of malaria epidemiology and providing an evidence base for maximizing the impact of control intervenfions. For this project comprehensive malaria surveillance studies will be conducted at 3 senfinel sites with widely varied epidemiology to collect data on measures of transmission intensity, infection and disease and identify opfimal methods for surveillance. Surveillance activities will then be streamlined and expand to 6 sentinel sites to measure the impact of key malaria control intervenfions on malaria transmission, infection, and disease. Our specific aims will be: 1) to identify opfimal strategies for malaria surveillance in Uganda by comparing different methodologies at mulfiple sites with varied transmission intensity, 2) to estimate the impact of key malaria control interventions on measures of transmission intensity, infecfion, and disease using surveillance data at mulfiple sites in Uganda, and 3) to conduct an economic evaluation of malaria control interventions to identify the optimal coverage levels and mix of interventions at mulfiple sites in Uganda.